Accident and Emergency waiting times are at their worst levels in a decade

A new report suggests that the number of patients forced to wait in accident and emergency (A&E) departments for more than four hours before receiving treatment, has hit its highest total in a decade. The four hour target was first implemented by the Labour government back in 2003/04.

Research carried out by health think tank The King’s Fund indicates that between October and December 2012, around 232,000 patients were waiting for more than four hours – equivalent to 4.3% of all the patients at A&E wards around the country. Although technically still reaching the government’s aim of 95% of patients being attended to in that time, it seems the situation has been getting steadily worse over the last few months.

The 95% target was reduced from 98% by the Coalition government who argued it enables doctors the facility to more efficiently study and treat complex cases and less urgent cases are not prioritised over the more serious ones.

The 232,000 patients stuck waiting for over four hours is a 21% increase contrasted against the same time period in 2011 and represents the highest number for those particular months since 2003.

In the report, it says: “The proportion of patients waiting more than four hours from arrival in A&E to admission, transfer or discharge in the third quarter of 2012/13 (October to December) rose by 21 per cent over the previous year and 38 per cent on the previous quarter. Nevertheless, overall, the NHS remained within target on this waiting times measure – although around a quarter, or 65 trusts recorded breaching the target during this quarter affecting more than 232,000 patients.”

Commenting on the findings, Professor John Appleby, Chief Economist at The King’s Fund said: “This is probably a combination of factors. By relaxing the target, the system will move towards that new relaxed level and is readjusting, plus demand is rising for A&E attendances and if the rest of the hospital is under pressure, and cannot discharge patients as quickly, you get a blockage in A&E. It doesn’t take much for things to start to go wrong. The percentages may look small but it is affecting a lot of people now. 232,000 in that quarter so nearing a million if that were repeated year round. Also the numbers of trusts it is affecting is increasing showing it is no longer just a problem for a few trusts.”

Some of the key points of the report were:

. Many patients who required admittance onto a ward were actually just being left on trolleys for long lengths of time.

. A survey of NHS finance directors found many were concerned about budgets, with a third complaining that the quality of patient care in their area had deteriorated in the previous year – double the number of those who had similar claims in the last survey.

. Around a quarter of all the countries hospital trusts have reported failures in meeting the A&E target – showing that the issue urgently needs addressing.

Prof Appleby added: “The NHS faces unprecedented financial pressures, and there are growing worries that patient care will suffer. For social care, it will be increasingly difficult for councils to make further savings without directly cutting services or affecting quality. Health and care services have coped well until now, but it is clear that many organisations expect things to become much more difficult over the coming year.”

Health Minister Lord Howe also spoke on the report and said: “Patients need to be able to rely on prompt, high quality, urgent and emergency care and treatment. We are clear that patients shouldn’t face excessive waits for treatment. Where there is extra demand on services, hospitals and staff need to work together to ensure that patients get the care they need.”

Anger at hospital patients being denied the latest treatments

A new report commissioned by the Department of Health (DoH) paints a damning picture of the NHS’ priorities and procedures, showing that they are inexplicably not prescribing the latest and most effective medications for bowel, brain, lung and ovarian cancer that have been previously given the green-light by NHS watchdog National Institute for Health and Clinical Excellence (NICE). The report details how often treatments approved by NICE are being prescribed by hospitals and GPs.

Some of the new treatments have incredibly prolonged the lives of terminally ill patients by over a year in some cases whilst others managed to improve the survival rates of patients by roughly a quarter, so the news that the drugs are not being utilised will no doubt infuriate families across the UK.

The same DoH report also documents how numerous hospitals are seemingly refusing to prescribe the most up-to-date treatments for other health conditions such as arthritis, asthma, Crohn’s Disease, heart attacks and multiple sclerosis.

It would also seem certain patients would benefit over others luckily by circumstance as some hospitals have been routinely prescribing the latest drugs for several years compared to others who have not bothered at all and sticking to oldest ‘tried and tested’ treatments, regardless of if there is anything potentially more effective for the patient.

Ministers and charities have blasted the findings of the DoH, saying it is ‘completely unacceptable’ that the new drugs have been held back for so long – some being approved by NICE seven years ago – and that hospital patients are being denied access to treatment that could significantly improve symptoms and even extend their life.

Specific reasons for the refusal of many hospitals to offer the new treatments to patients can be only speculation until answers are demanded from the government, but some believe it may be because doctors are cautious to prescribe drugs they are not fully familiar with and will instead remain with treatments they have trusted over the years.

Health Minister Lord Howe reacted angrily to the news and said: “Patients have a right to medicines and treatments that have been approved by NICE and are clinically appropriate for them, and it is completely unacceptable if this is not happening. We are determined to drive out unjustified variation.”

Adding to Lord Howe’s comments was Andrew Wilson, Chief Executive of the Rarer Cancers Foundation, who said: “NICE was meant to end the postcode lottery but these figures show that it is alive and well. Access to drugs should not depend on where you live or in which hospital you are treated.”

Although health officials protest that the information contained in the report is ‘experimental’ and too early to draw conclusions, some facts are plain to see and include the staggering news that a drug for advanced bowel cancer has not been utilised at any time by at least 25 hospital trusts – despite receiving NICE approval way back in 2006.

Other findings show that 15 trusts are spurning the opportunity to provide the drug Erlonitib to lung cancer patients. It works at preventing the development of tumours for approximately a year and was approved by NICE in 2008.

However, it gets worse – it has been discovered that there are 24 trusts around to country who are not offering the drug Paclitaxel to women with advanced ovarian cancer. If they had the medication, it could extend their lifespan by an additional year.

Katherine Murphy, chief executive of the Patients Association, also gave her opinion on the subject, saying: “Patients have the right to drugs and treatments that have been recommended by NICE for use in the NHS, if their doctor says they are clinically appropriate. Any perception that there is a rationing of NICE approved medication taking place at a local level is a real concern.”